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WO2003077733A3 - Method and apparatus for accessing the left atrial appendage - Google Patents

Method and apparatus for accessing the left atrial appendage Download PDF

Info

Publication number
WO2003077733A3
WO2003077733A3 PCT/US2003/008044 US0308044W WO03077733A3 WO 2003077733 A3 WO2003077733 A3 WO 2003077733A3 US 0308044 W US0308044 W US 0308044W WO 03077733 A3 WO03077733 A3 WO 03077733A3
Authority
WO
WIPO (PCT)
Prior art keywords
atrial appendage
left atrial
accessing
sheath
specifically
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2003/008044
Other languages
French (fr)
Other versions
WO2003077733A2 (en
Inventor
Alexander K Khairkhahan
Andrew G C Frazier
Alan R Klenk
Marc S Kreidler
Stewart M Kume
Darrell H Ogi
Chad C Roue
Der Burg Erik J Van
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ev3 Peripheral Inc
Original Assignee
Ev3 Sunnyvale Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ev3 Sunnyvale Inc filed Critical Ev3 Sunnyvale Inc
Priority to AU2003225822A priority Critical patent/AU2003225822A1/en
Publication of WO2003077733A2 publication Critical patent/WO2003077733A2/en
Publication of WO2003077733A3 publication Critical patent/WO2003077733A3/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/32Surgical cutting instruments
    • A61B17/3203Fluid jet cutting instruments
    • A61B17/32037Fluid jet cutting instruments for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • A61B17/3423Access ports, e.g. toroid shape introducers for instruments or hands
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/3207Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320725Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with radially expandable cutting or abrading elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/3207Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/32075Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3478Endoscopic needles, e.g. for infusion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/32Surgical cutting instruments
    • A61B17/320016Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/00234Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation
    • A61B2017/00243Type of minimally invasive operation cardiac
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/00234Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation
    • A61B2017/00243Type of minimally invasive operation cardiac
    • A61B2017/00247Making holes in the wall of the heart, e.g. laser Myocardial revascularization
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00778Operations on blood vessels
    • A61B2017/00783Valvuloplasty
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421Cannulas
    • A61B17/3423Access ports, e.g. toroid shape introducers for instruments or hands
    • A61B2017/3425Access ports, e.g. toroid shape introducers for instruments or hands for internal organs, e.g. heart ports
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • A61B2018/00392Transmyocardial revascularisation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0075Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • A61B5/0086Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters using infrared radiation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0082Catheter tip comprising a tool
    • A61M25/0084Catheter tip comprising a tool being one or more injection needles

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Molecular Biology (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Pathology (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • Surgical Instruments (AREA)

Abstract

An apparatus for facilitating access to the left atrium, and specifically the left atrial appendage. The apparatus includes a sheath (74) with first and second curved sections (110, 130) that facilitate location of the fossa ovalis and left atrial appendage. The apparatus further includes tissue piercing (42) and dilating structures (20).
PCT/US2003/008044 2002-03-15 2003-03-14 Method and apparatus for accessing the left atrial appendage Ceased WO2003077733A2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2003225822A AU2003225822A1 (en) 2002-03-15 2003-03-14 Method and apparatus for accessing the left atrial appendage

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US10/100,270 US7056294B2 (en) 2000-04-13 2002-03-15 Method and apparatus for accessing the left atrial appendage
US10/100,270 2002-03-15

Publications (2)

Publication Number Publication Date
WO2003077733A2 WO2003077733A2 (en) 2003-09-25
WO2003077733A3 true WO2003077733A3 (en) 2004-04-08

Family

ID=28039764

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2003/008044 Ceased WO2003077733A2 (en) 2002-03-15 2003-03-14 Method and apparatus for accessing the left atrial appendage

Country Status (3)

Country Link
US (3) US7056294B2 (en)
AU (1) AU2003225822A1 (en)
WO (1) WO2003077733A2 (en)

Cited By (12)

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US7220265B2 (en) 2002-01-14 2007-05-22 Nmt Medical, Inc. Patent foramen ovale (PFO) closure method and device
US7318833B2 (en) 2001-12-19 2008-01-15 Nmt Medical, Inc. PFO closure device with flexible thrombogenic joint and improved dislodgement resistance
US7431729B2 (en) 2002-06-05 2008-10-07 Nmt Medical, Inc. Patent foramen ovale (PFO) closure device with radial and circumferential support
US7473260B2 (en) 2003-09-11 2009-01-06 Nmt Medical, Inc. Suture sever tube
US8029470B2 (en) 2004-09-30 2011-10-04 Pacesetter, Inc. Transmembrane access systems and methods
US8870913B2 (en) 2006-03-31 2014-10-28 W.L. Gore & Associates, Inc. Catch system with locking cap for patent foramen ovale (PFO) occluder
US9005242B2 (en) 2007-04-05 2015-04-14 W.L. Gore & Associates, Inc. Septal closure device with centering mechanism
US9017373B2 (en) 2002-12-09 2015-04-28 W.L. Gore & Associates, Inc. Septal closure devices
US9241695B2 (en) 2002-03-25 2016-01-26 W.L. Gore & Associates, Inc. Patent foramen ovale (PFO) closure clips
US9259267B2 (en) 2005-09-06 2016-02-16 W.L. Gore & Associates, Inc. Devices and methods for treating cardiac tissue
US9585692B2 (en) 2007-10-19 2017-03-07 Pressure Products Medical Supplies Inc. Transseptal guidewire
US11304753B2 (en) 2019-09-13 2022-04-19 Alleviant Medical, Inc. Systems, devices, and methods for forming an anastomosis

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US6379334B1 (en) 1997-02-10 2002-04-30 Essex Technology, Inc. Rotate advance catheterization system
US7128073B1 (en) 1998-11-06 2006-10-31 Ev3 Endovascular, Inc. Method and device for left atrial appendage occlusion
US6855123B2 (en) 2002-08-02 2005-02-15 Flow Cardia, Inc. Therapeutic ultrasound system
US8506519B2 (en) 1999-02-16 2013-08-13 Flowcardia, Inc. Pre-shaped therapeutic catheter
US6488689B1 (en) 1999-05-20 2002-12-03 Aaron V. Kaplan Methods and apparatus for transpericardial left atrial appendage closure
US6939361B1 (en) 1999-09-22 2005-09-06 Nmt Medical, Inc. Guidewire for a free standing intervascular device having an integral stop mechanism
AU7720100A (en) 1999-09-27 2001-04-30 Essex Technology, Inc. Rotate-to-advance catheterization system
US8091556B2 (en) 2001-04-20 2012-01-10 V-Wave Ltd. Methods and apparatus for reducing localized circulatory system pressure
WO2005074367A2 (en) 2004-02-03 2005-08-18 Atria Medical Inc. Device and method for controlling in-vivo pressure
US20080114394A1 (en) 2001-04-24 2008-05-15 Houser Russell A Arteriotomy Closure Devices and Techniques
US8992567B1 (en) 2001-04-24 2015-03-31 Cardiovascular Technologies Inc. Compressible, deformable, or deflectable tissue closure devices and method of manufacture
US20090143808A1 (en) * 2001-04-24 2009-06-04 Houser Russell A Guided Tissue Cutting Device, Method of Use and Kits Therefor
US8961541B2 (en) 2007-12-03 2015-02-24 Cardio Vascular Technologies Inc. Vascular closure devices, systems, and methods of use
US6702835B2 (en) 2001-09-07 2004-03-09 Core Medical, Inc. Needle apparatus for closing septal defects and methods for using such apparatus
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US20020169377A1 (en) 2002-11-14
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US9131849B2 (en) 2015-09-15
AU2003225822A8 (en) 2003-09-29
US20060009715A1 (en) 2006-01-12
AU2003225822A1 (en) 2003-09-29
US20150359563A1 (en) 2015-12-17

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